Frequent illness not necessarily worrisome

Dr. Diana Blythe

Q:My daughter is 2 years and 5 months old and keeps getting sick! This is the fifth time in less than a month. I took her to the pulmonologist, and she was prescribed Xopenex. She got better for almost a week, [then] got a 103 fever from out of the blue that lasted one day and then went away for a week. Then yesterday she got 102 fever again. The pediatrician said nothing to worry about and to give her Tylenol. Is this normal? Is there anything I can do so she doesn’t get sick so often?

A: Wow, it sounds like you are getting quite worried! Hopefully, I can make you feel a little better.

When children are toddlers, they get sick frequently with viruses. Because their immune systems are seeing these normal childhood illnesses for the first time, they get sick. The good news is that each time they catch a virus, children build their immunity by making antibodies. Given the fact that your daughter had three separate fevers separated by one month and then two weeks, she still falls into the range of normal.

Xopenex is a medicine that opens up the smaller airways of the lungs so she can breathe more easily. It is for symptom control and does not cure. If she never needs Xopenex again, it was likely just a childhood illness. Most kids have wheezed at some point in their lives. However, if she starts to need Xopenex with every cold virus, she may have extra-sensitive airways. If this happens, please talk to your pediatrician about the possibilities.

Make sure she gets enough sleep, proper nutrition and practices good hand-washing. In addition, please consider a yearly flu vaccine, and remember, no school or day care for at least 24 hours after the last fever or fever reducer.

Q:Are there any real benefits to male circumcision.

A: For a long time, it was thought that male circumcision protected against urinary tract infections. But as more published studies showed this commonly held belief was not proved true without confounding factors, the American Academy of Pediatrics moved away from recommending routine male circumcision. In addition, some insurance companies do not even cover circumcision because it is not medically necessary for most boys.

Now you may be wondering about those confounding factors I mentioned. When some of the studies were done, they included premature infants who were not circumcised because they had not been discharged from the hospital yet. The boys did have increased risk of urinary tract infections, but prematurity is a risk for urinary tract infection by itself. We do not know if these boys had urinary tract infections because they were premature or uncircumcised. Because of this possible confounding factor, we cannot count these particular studies that show increased rates of urinary tract infection in uncircumcised males.

There are some medical reasons to consider circumcision, and your pediatrician will tell you when one of these arises. Families should be made aware of both the risks and the benefits. Some possible risks include bleeding and infection, whereas potential benefits can involve decreased risk of some sexually transmitted diseases later in life.

Mainly, it becomes a personal choice for the family. Sometimes the decision is made for cultural or religious reasons.